Provider Demographics
NPI:1669763322
Name:MCKEE, BRUCE DALE
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:DALE
Last Name:MCKEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 13TH PLACE NE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321
Mailing Address - Country:US
Mailing Address - Phone:541-926-1833
Mailing Address - Fax:
Practice Address - Street 1:581 A STREET
Practice Address - Street 2:MILITARY SEALIFT COMMAND
Practice Address - City:NORFLOK
Practice Address - State:VA
Practice Address - Zip Code:23511-4295
Practice Address - Country:US
Practice Address - Phone:866-827-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman